Additional Notes: The Orientation 2016 page includes all the forms you need to complete as a new hire, along with additional information about your

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Dominick Anthony
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The Pension & Benefits Department page includes a lot of forms that you may need during your employment: life

3 Additional Notes: The Orientation 2016 page includes all the forms you need to complete as a new hire, along with additional information about your benefit options. The Pension & Benefits Department page includes a lot of forms that you may need during your employment: life insurance beneficiary forms, medical claim forms, dental claim forms, etc. Our webpage also puts up information about events of interest, such as the annual medical Open Enrollment period. 3

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If your question is general, you may receive a quick reply.

6 Other contact information for the TRB: Mailing Address : CT Teachers' Retirement Board 765 Asylum Avenue Hartford, CT Additional Notes: trb.webmaster@ct.gov. Your question will be routed to the appropriate staff member. If your question is general, you may receive a quick reply. If your question requires research, your reply may be delayed or sent via regular mail. Specific department phone numbers and addresses are listed on the TRB website under Contact Us 6

Additional Notes: Enrolling within 31 days of this initial offer comes with guaranteed issue when you submit your enrollment form, you are set up with the

With underwriting, you could be denied the coverage. When enrolled, you can drop your supplemental life insurance at any time by requesting another.

7 Additional Notes: Enrolling within 31 days of this initial offer comes with guaranteed issue when you submit your enrollment form, you are set up with the additional coverage without further questions or forms. Underwriting involves a different application process and includes questions about your health. With underwriting, you could be denied the coverage. When enrolled, you can drop your supplemental life insurance at any time by requesting another. Re-enrolling after cancelling must go through underwriting. Keep in mind that it is easier to enroll now and drop it later than it would be to waive now and enroll later. 7

dental and vision expenses such as orthodontics, eyeglasses, etc. You would not be able to use FSA funds for medical or pharmacy expenses.

8 Additional Notes: You do not have to be enrolled in a City medical plan to sign up for a Health Care FSA or Dependent Care FSA. They are separate, optional benefits. If you enroll in the Health Care FSA while also enrolling in our high deductible health plan with an Health Savings Account (HSA), your Health Care FSA would be limited to dental and vision expenses such as orthodontics, eyeglasses, etc. You would not be able to use FSA funds for medical or pharmacy expenses. This is to protect you from being liable for tax penalties on contributions made to your HSA. The dependent care account does not cover out-of-pocket medical expenses for children you would use the Health Care FSA for that purpose. 8

Enrollment, which is typically around November.

9 Additional Notes: The FSA benefit period for new WTA & SAW members for this year is 9/1/16 12/31/16. If you do not enroll now as a new employee, your next opportunity to enroll in an FSA would be during FSA Open Enrollment, which is typically around November. That enrollment would be for the 2017 calendar year, 1/1/17 12/31/17. Exact enrollment dates will be announced later this year and will be displayed on the Pension & Benefits Department webpage. 9

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of the calendar year. The FSA Open Enrollment for 2017 will be online.

11 Additional Notes: When completing the FSA enrollment form as a new hire, note that the total amount you elect to contribute will be divided evenly into your paychecks for the remainder of the calendar year. The FSA Open Enrollment for 2017 will be online. Instructions for enrolling for 2017 will be posted on the Pension & Benefits Department website later this year. 11

Additional Notes: You have 31 days to enroll in medical, pharmacy, and dental benefits as a new hire. When you enroll as a new employee, your coverage is effective 9/1.

If you enroll at that time, coverage begins 9/1/2017. There are certain times when you can enroll outside of Open Enrollment, which are known as qualifying events.

12 Additional Notes: You have 31 days to enroll in medical, pharmacy, and dental benefits as a new hire. When you enroll as a new employee, your coverage is effective 9/1. If you miss the new hire deadline, your next opportunity to enroll would be during the 2017 Medical Open Enrollment, which is typically in May and June. If you enroll at that time, coverage begins 9/1/2017. There are certain times when you can enroll outside of Open Enrollment, which are known as qualifying events. For example, if you are automatically taken off of a parent s plan because you are turning 26 or if you are losing coverage because your spouse s job is terminating. With qualifying events, you typically have only 31 days to enroll in our plan from the date your other coverage ends. You will be required to provide written proof of the qualifying event, such as a notice of insurance termination. For specific requirements, please refer to the Qualifying Events Checklist on the Pension & Benefits Department webpage. 12

January through June you pay a little more each pay to cover for the summer months. It is not a new premium, just an adjustment for the summer when you do not have any deductions.

13 Additional Notes: Rates are provided online as well as in your packets Premiums are pre-tax and are only deducted from 20 payrolls. Nothing will come out of your 3 rd check in a month or for July and August. Refer to Rate sheet: September through December you pay the normal premium required. January through June you pay a little more each pay to cover for the summer months. It is not a new premium, just an adjustment for the summer when you do not have any deductions. If you decide not to return for the new school year ( ), you will still be covered for the summer. Open enrollment is offered every year and only once a year for changes to your plan, individuals covered and rates. New rates are set again in September. Open Enrollment runs usually from mid May through mid June. 13

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Additional Notes: Once you are enrolled in our health plan, it is recommended that you download the app to your phone and/or register online. This feature allows you to: 1.

Check your balance in your deductible as well as HSA balance. The City uses one network and this network is nationwide.

15 Additional Notes: Once you are enrolled in our health plan, it is recommended that you download the app to your phone and/or register online. This feature allows you to: 1. Carry your insurance cards wherever you go. 2. Provide physician names and their locations for specific conditions or upcoming procedures; compare costs. 3. Check your balance in your deductible as well as HSA balance. The City uses one network and this network is nationwide. Meaning if a Dr accepts Cigna s Open Access Plus network in New Mexico, you are considered In-Network. This network is great especially if you or a family member want o seek treatment outside of CT. Emergency and Urgent Care is covered as In-Network even if the facility is Out of Network as long as it is for an emergency (i.e.- broken leg, heart attack, etc) 15

The familiar co-pay plan structure. Additional Notes: All in-network service will only have a co-pay as outlined. Out of network services will first involve a deductible that you must pay for.

Allowable costs are the cost that Cigna has set and will only pay what they would have paid if the services were used with an In Network physician or facility. The OAP offers: 1.

16 The familiar co-pay plan structure. Additional Notes: All in-network service will only have a co-pay as outlined. Out of network services will first involve a deductible that you must pay for. Then coinsurance where Cigna will pick up a % of the allowable costs and you will be billed the balance. Allowable costs are the cost that Cigna has set and will only pay what they would have paid if the services were used with an In Network physician or facility. The OAP offers: 1. An additional Oral Surgery rider. Our dental plan covers 50% of the surgery after a deductible. The city also only has a $1,000 max per year on dental so any balance is put back on the patient. The additional rider will help pay the remaining 50% minus the anesthesia. 2. Infertility is covered 100% with no limitation on usage. 3. No cap on pharmacy. Only co-pays 16

Additional Notes: The High Deductible Health Plan (HDHP) is a consumer driven plan. You will see actual costs and discounts that are provided with having Cigna as our healthcare provider.

No differences; just the patient cost at the point of service. Preventive today is covered at 100% because of healthcare reform.

17 Additional Notes: The High Deductible Health Plan (HDHP) is a consumer driven plan. You will see actual costs and discounts that are provided with having Cigna as our healthcare provider. All accumulated costs for medical & pharmacy go towards your deductible. The HDHP uses the Open Access Plus network and the coverage for the plan is the same as the OAP co-pay plan. No differences; just the patient cost at the point of service. Preventive today is covered at 100% because of healthcare reform. Preventative services such as your child s wellness visit is covered 100%. No cost to the member. Be aware of what is deemed preventative. Ex. Mammograms, Ultrasounds, Colonoscopy and EKGs may be of a preventative nature but if you were diagnosed with breast cancer and continue to have routine mammograms, these are no longer preventative. A preventative colonoscopy can turn to be a diagnosis if they find a cancerous polyp. Diabetic Supplies and medications are 100% covered with no out of pocket cost to the member or family PLEASE REVIEW YOUR CBA FOR THE FOLLOWING YEARS HDHP DEDUCTIBLE AND EMPLOYER CONTRIBUTION 17

Generally this is to prepare even if you don t expect to use the plan or if you have expenses for items other than the deductible like glasses or contacts,

18 Employer funding is a definite. Additional Notes: Employee funding is a choice. Contribution forms are available online and in your packet. Employees can fund their portion of the deductible as well as other $$ into their HSA. Generally this is to prepare even if you don t expect to use the plan or if you have expenses for items other than the deductible like glasses or contacts, braces, Lasik surgery, etc. Funding through payroll deduction is done on a pre-taxed basis. WTA members will receive full funding at the start of the plan after they enroll. SAW members will receive a portion of the funding during the next quarterly installment. 18

Additional Notes: Contributions on the employee level are not required. You can contribute based on meeting the deductible or beyond that amount. The money is yours once it is deposited.

IRS LIMITS: Active employees can contribute any amount they choose as long as total combined (employer & employee) deposits do not exceed the Federal Maximum HSA Deposit Limits.

19 Additional Notes: Contributions on the employee level are not required. You can contribute based on meeting the deductible or beyond that amount. The money is yours once it is deposited. Build a balance to help in retirement. IRS LIMITS: Active employees can contribute any amount they choose as long as total combined (employer & employee) deposits do not exceed the Federal Maximum HSA Deposit Limits. If you go over the IRS limits in a Calendar Year you will get taxed and penalized. For 2016 the Limit is $3,350 per Individual and $6,750 per Family. For example: WTA members electing to contribute to the full federal maximum may contribute: Single $2,450 Family $4,950 Employees 55 years or older are permitted to make an additional $1,000 contribution annually. Health Reimbursement Account (short is HRA): The HRA is a safeguard for those who want to enroll in the City s HDHP but cannot have the HSA due to IRS regulations. 19

Additional Notes: Coverage is the same for the OAP and the HDHP You can get a 30 day supply at any participating retail pharmacy (Costco, CVS, Rite-Aid, Walgreens, Bunker Hill Pharmacy, East Main,

20 Additional Notes: Coverage is the same for the OAP and the HDHP You can get a 30 day supply at any participating retail pharmacy (Costco, CVS, Rite-Aid, Walgreens, Bunker Hill Pharmacy, East Main, etc) Mail Order through ESI is a 90 days supply for most Rx. The cost for the most part is cheaper than any other retail pharmacy but you should shop around. Prescriptions are placed into a tier (Generic, Preferred, Non-Preferred). These levels can change based on the FDA and other circumstances. Be aware if you wish to take a brand name but a generic is available, you may be balanced billed if your DR did not specify this on the prescription. Co-pays for the pharmacy are: $5 / $30 / $45 retail (WTA) $10 / $30 / $45 retail (SAW) If you enroll in the HDHP, you will pay the full cost of the RX (discounted negotiated rate) until the deductible is met, then you are responsible for a co-pay. 20

21 One dental plan Additional Notes: It is optional but you cannot have dental only 21

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24 Additional Notes: TRB: mandatory contributions are 6% regular contributions and 1.25% health contributions. 24

25 Extra Classes Additional Notes: This will eliminate the need for an adjustment on your last check(s) of the year. 25

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Additional Notes: For Section 1, you do not need to complete the fields marked Employer Name or Customer Number. You do not need to complete Section 2.

For example, you can assign 50% each to two beneficiaries, or you could split it 60/40, or 70/30, etc. If you have only 1 primary beneficiary, please indicate 100%.

27 Additional Notes: For Section 1, you do not need to complete the fields marked Employer Name or Customer Number. You do not need to complete Section 2. For Section 3, we need at least one primary beneficiary. It does not need to need to be a spouse or family member. Be sure to indicate the percentage of proceeds. For example, you can assign 50% each to two beneficiaries, or you could split it 60/40, or 70/30, etc. If you have only 1 primary beneficiary, please indicate 100%. Contingent beneficiaries are optional. Be sure to print your name, signature, and date in Section 6. You are welcome to update your beneficiaries at any time by submitting a new form to the Pension & Benefits Department. 27

Additional Notes: Please complete all fields of the Healthcare Enrollment/Change Form, including the Social Security Numbers for all individuals to be added to coverage.

If you do add a spouse or children, all supporting documentation (marriage certificated photocopies, etc.) must be submitted within the 31 day deadline.

28 Additional Notes: Please complete all fields of the Healthcare Enrollment/Change Form, including the Social Security Numbers for all individuals to be added to coverage. You do not need to complete the Dependent Eligibility Affidavit if you are not adding a spouse or children. If you do add a spouse or children, all supporting documentation (marriage certificated photocopies, etc.) must be submitted within the 31 day deadline. Persons listed on your application without the required supporting documents will not included and cannot be added until the next Open Enrollment or during a Qualifying Event. See the Qualifying Event Checklist on the Pension & Benefits Department webpage for additional information. For each child to be added, you must include a photocopy of the full-page birth certificate, not the card-size form. If you have an adopted child, Legal Guardianship, or Qualified Medical Child Support Order (QMCSO) please contact our department or refer to the Qualifying Event Checklist for documentation requirements. 28

29 Additional Notes: You must complete a Medical Insurance Waiver Form if you do not wish to enroll in medical insurance through the City of Waterbury. 29

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Welcome to BorgWarner!

Welcome to BorgWarner! We are excited to begin sharing the many benefits of belonging to BorgWarner. This Preview of the medical plans is just one of a series of communications you ll receive throughout